State Implementation of the Affordable Care Act: Practical Concerns Final

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Transcript of State Implementation of the Affordable Care Act: Practical Concerns Final

Limited public awarenessUninsured is a diverse groupPublic education campaigngrassrootssocial mediaearned mediapaid advertisementspartnerships- public and privateFederal Exchange "Plus" Model Emerging?3States have a love-hate relationship with federal regulationsGovernance battles are playing out within states8Exchanges will not start as an active purchaser in most of the country, but this could change7Some state-based health insurance exchanges have created new models of transparency and stakeholder engagement5All but three states have a long way to go to align with ACA's commercial insurance market reforms4The Medicaid expansion decision gets all the attention, but it is only one decision on a state’s long Medicaid related ACA to-do list1It is now “prime time” for states implementing the health reform law9So much depends on who enrolls and not just how many enroll6Takes only a minute to create a profile and connect with more than 5,000 health reform thinkers and doersstatereforum.org/user/registerSee what states are talking aboutAsk a QuestionSee You Online!www.statereforum.orgShare Your Presentations, Analysis, Researchand IdeasExpand Medicaid?BenefitsAlternative Benefit PlansNew Preventive Benefits Standards CoverageOperationsIT System UpgradesSafeguarding InformationIncrease in Primary Care Reimbursement RatesFinancingEnhanced CHIP FMAPEnhanced Federal FundingEligibility and Enrollment Maintenance of EffortMandatory Coverage ExpansionsNew Income Eligibility RulesMedicaid-Related ACA ReformsAttorney General HoodGary Cohen, CCIIOFederal Partnership ExchangesPlan ManagementConsumer AssistanceBothState-based exchanges are another opportunity for states to align their health policy vision and goals2Example #1 Mississippi10All the work will not be done on Jan 1, 2014. Do your part to help your state succeed now and in 2014 and beyond!IowaArkansasDelawareIllinoisMichiganNew HampshireWest VirginiaInsurance Commissioner ChaneyConsumer AssistanceConsumer Facing SiteMultiple Options AccessibilityGuidance Final RegulationProposed RegulationWays to help your state succeed:2014 is todayMedicaid Expansion as crafted in ACA unconstitutional

State choice to expand or notSCOTUSCMSWe need flexibility

Let us do a partial Medicaid expansionIf you want the 100% match rate, you have to expand all the way to 138% FPLGovernors'Appeal to HHSEHB RegulationsGuidance on Partial Medicaid ExpansionCheck out "highlights" like tracking charts on Medicaid and Exchange Policy DecisionsMarket research around communications and public awareness Segmenting audiences Using trusted community organizations Media buys through radio, TV, print materialsNumber of days until open enrollment: 214

Number of Days until coverage starts: 306Gather ideas from other states that might solve problems in your state.

In state exchange states, participate and provide input into policy decisions happening now.

In federally facilitated exchange states, focus on state role regulating insurance and assisting consumers.

Educate your students, the media, colleagues, and friends and family on the ACA, states role in making it work, and who to hold accountable.

Contribute to scholarship or grey literature as issues emerge about what is working and what isn't. How might emerging problems be solved? What are the state and federal legal, regulatory, and policy and practice fixes needed to improve?1. It is now “prime time” for states implementing the health reform law2. Governance battles are playing out within states3. States have a love-hate relationship with federal regulations4. The Medicaid expansion decision gets all the attention, but it is only one decision on a state’s long Medicaid related ACA to-do list5. All but three states have a long way to go to align with ACA's commercial insurance market reforms6. State-based exchanges are another opportunity for states to align their health policy vision and goals7. Some state-based health insurance exchanges have created new models of transparency and stakeholder engagement8. Exchanges will not start off as an active purchaser in the majority of the country, but this could change9. So much depends on who enrolls and not just how many enroll10. All the work will not be done on Jan 1, 2014. Do your part to help your state succeed now and in 2014 and beyond!State Implementation of the Affordable Care Act: Ten Practical ConsiderationsGovernor Bryant